Many patients with rare diseases require some sort of treatment or therapy to manage their conditions. In the case of atypical hemolytic-uremic syndrome, or aHUS, this therapy is dialysis. Learn about the two main types of dialysis used to reduce the risk of aHUS complications.
Atypical Hemolytic-Uremic Syndrome (aHUS)
Atypical hemolytic-uremic syndrome (aHUS) is a (mostly) inherited disorder which negatively impacts kidney function. This condition, which can occur at any age, causes small blood clots to form in the kidneys. Normally, kidneys filter excess waste, fluid, and salt from the body. So, these blood clots cause kidney damage. Additionally, the National Organization for Rare Disorders (NORD) explains that aHUS is categorized by:
low levels of circulating red blood cells due to their destruction, low platelet count due to their consumption, and inability of the kidneys to process waste products from the blood and excrete them into urine.
Toxins cause typical HUS. However, aHUS is 10x less common than tHUS. aHUS tends to affect women more, particularly around pregnancy. Symptoms include fatigue, irritability, high blood pressure, blood in the urine, and acute kidney failure. People with aHUS are also more likely to develop complications than those with tHUS. As a result, up to 68% of patients with aHUS require dialysis to help with filtering waste.
Read more about atypical hemolytic-uremic syndrome.
Types of Dialysis
Hemodialysis for aHUS
Hemodialysis helps filter waste out of the body, much like the kidneys would do if healthy. First, two needles are placed in a patient’s arm. Next, blood is removed and cycled through a dialysis machine. Specifically, it is run through a “dialyzer,” or a special filter. This removes waste while balancing levels of sodium, calcium, and potassium. Clean, filtered blood is then returned to the body.
Hemodialysis can take up to a few hours, and must be performed multiple times per week. This helps patients with aHUS by replacing some kidney function and improving energy. Ultimately, this leads to a higher quality of life. Although hemodialysis can be performed at home, many patients visit a hospital or doctor’s office. Learn more here.
Peritoneal Dialysis for aHUS
Peritoneal dialysis uses part of your own body – your peritoneum, or abdomen lining – to help filter blood. First, doctors place a catheter in an abdominal incision. Next, doctors pump dialysate through the catheter. According to the Kidney Fund, dialysate is a cleaning solution that absorbs excess fluid and waste. Then, patients wait for a “dwell time” between 30-40 minutes. Finally, waste is drained from the body. The process is repeated for anywhere from 4-6 hours. Generally, this is considered continuous ambulatory peritoneal dialysis (CAPD).
However, peritoneal dialysis can also be continuous cycler-assisted (CCPD). This occurs throughout the night while a patient sleeps using a cycler machine. CCPD generally takes around 9 hours to complete 3-5 cycles.
Potential Issues with Dialysis
If you have aHUS, make sure to talk to your doctor about dialysis and associated risks. These include:
- Muscle cramps or fatigue
- Pericarditis, or swelling around the heart’s membrane
- Weight gain
- Abdominal hernia
However, your care team will assist you in choosing the right option for your needs.